HIV/AIDS Newsroom: December 28, 2000

In response to President Clinton's 1997 challenge to scientists that an AIDS vaccine be developed within 10 years, the Dale and Betty Bumpers Vaccine Research Center at the National Institutes of Health, located in Bethesda, Maryland, will open in spring 2001. Costing between $35 and $40 million to construct, the center will house all levels of scientific research techniques needed in the search for an AIDS vaccine. Center director Gary Nabel believes that although the primary focus of the center is to develop a vaccine against AIDS, the broader mission is to find vaccines for all diseases. He predicts that within 10 years,
there will be a vaccine of sorts for AIDS, but whether it will be optimal or not is hard to say "because the [clinical] trials take so long."

In late March, Merck Chairman and CEO Raymond V. Gilmartin told World Health Organization (WHO) Director-General Gro Harlem Brundtland that five large drug firms had agreed in principle to provide deep discounts on their AIDS drugs to people in poor countries. Gilmartin asked Brundtland if she wanted to sponsor the initiative, and a deal was announced with much fanfare less than two months later. However, interviews with some of the
participants and documents obtained by the Washington Post indicate that there were problems between the five drug companies and five international agencies from the beginning. The agencies' unspoken objective was to lower the prices of patented drugs to the level of generics and to increase the drugs' availability, while the pharmaceutical companies tried to
maintain prices in many markets by providing selective discounts and worked to end a heated debate over drug prices and patents. In response to criticism regarding the high cost of their drugs, the drug industry asserted that social, managerial, and political barriers are among the true hindrances to obtaining AIDS drugs in poor nations. The industry also noted the high cost of research and development. Since the deal was announced in May, Glaxo Wellcome has been the only one of the five companies to reveal its price cuts. The companies are mostly working out the lower drug price deals for each drug in each country. The only
completed deal so far is in Senegal, where an estimated 79,000 people are infected with HIV, although an agreement for Uganda is not far off.

Across the United States, the number of groups that are encouraging abstinence until marriage has grown since an amendment to the Welfare Reform Act of 1996 increased federal funding for promoting chastity. Until that time, such funding totaled $60 million since 1981; however, the new measure allocated $250 million over five years. The new law also prohibits participating programs from promoting use of condoms or contraception. As part of the abstinence-until-marriage programs, young people are taught to consider ads, television shows, and movies that show sex between single people with skepticism. While polls indicate that most parents want schools to promote not having sex until marriage, studies also show that parents want young people to be instructed about protection if they do indeed have intercourse. According to Douglas Kirby of Education, Training and Research Associates in California, a group which promotes abstinence but also emphasizes the need for condoms and contraception, three studies of abstinence programs have shown insufficient evidence that they postpone intercourse. Furthermore, a committee on HIV prevention from the National Academy of Sciences called funding abstinence-only programs "poor fiscal and public health policy." A panel convened by the National Institutes of Health three years ago also said the programs are an obstacle to reducing teenagers' risky behaviors. Statistics show that 50 percent of all new HIV infections in the United States are in young people under the age of 25.

Oklahoma will receive more federal funding for its educational programs designed to teach teenagers the virtues of sexual abstinence, according to U.S. Rep. Ernest Istook (R-Okla.) and state health officials. President Clinton signed a bill last week that will increase the amount of funding for states to use in this type of program. Oklahoma currently operates six
abstinence programs that cover at least 21 counties and has already received almost $1 million dollars in federal assistance to promote and run abstinence education for teens. Jerry Regier, Oklahoma's secretary for health and human services, noted that the state plans to apply in 2001 for $3 million in federal funding to conduct abstinence programs over a three-year period. "We think the abstinence education program is incredibly important to Oklahoma," he said.

The recent report from the United Nations warns that prostitution and drug use are the primary reasons for the spread of HIV in previously unaffected communities in eastern Europe and Africa. The report estimates that there were 3.8 million new infections in sub-Saharan Africa in 1999, bringing the total for the entire area to over 25 million. UNAIDS head Dr. Peter Piot commented, "The AIDS situation in Africa is catastrophic and sub-Saharan Africa continues to head the list as the world's most affected region." Piot noted that socio-economic instability in many of the countries has resulted in increases in drug use and
prostitution, both of which are risk factors for HIV infection.

Millions of Americans have hepatitis C, although most are unaware of their infection. The bloodborne virus, which slowly attacks the liver, will take the lives of an estimated 8,000 to 10,000 Americans this year. The Centers for Disease Control and Prevention's 2000 budget for hepatitis C programs was $12.9 million, including $1.8 million for education. In contrast, the CDC's budget for HIV/AIDS prevention and surveillance was $678 million. In July, Surgeon General David Satcher wrote a letter that was to be mailed to all U.S. households, warning residents about the "silent epidemic" of hepatitis C. However, postal
budget cuts at the surgeon general's office and the Department of Health and Human Services prevented the letter from being printed and sent; Satcher urged members of Congress to use their postage funds to send the letter, but many did not. Next year, 15 states will receive a $70,000 CDC grant to hire a hepatitis C coordinator, someone who will develop a hepatitis C prevention and counseling message, work with regional health authorities on reporting cases, and track all cases to determine patient needs.

Starting next year, Western-made female condoms will be available in China, where at least 500,000 people are infected with HIV. A report in the Shanghai Daily indicated that the Female Health Company of Chicago has registered its Femidom female condom in China, and is working with a local firm to market the condom online. Xu Jinxun of Shanghai's Municipal Commission for Population and Family Planning surveyed 30 couples about Femidom two years ago. According to the newspaper report, 90 percent of the husbands and wives thought the product was acceptable, and 80 percent of women and 73 percent of men said it was preferable to the male condom. Domestically made condoms were introduced in China last year, but they have not been much of a hit, with cost and comfort cited as two main issues.

An AIDS education leaflet was introduced to regional authorities and members of nongovernmental organizations in Sikasso, Mali, this week. The leaflet was designed by the Malian ministry for women's promotion, children, and family affairs with the help of the Church of Norway to increase AIDS awareness, particularly among women and young people. Sikasso, a migrant border town to the Côte d'Ivoire, has an HIV prevalence of 5 percent, while the national average is 3 percent.

A new law in Kyrgyzstan offers amnesty to nearly 50 percent of the prisoners in the country. According to human rights activist Tursunbai Bakir-uulu, amnesty will be available to individuals convicted of petty crimes who received sentences of five years or less. The first group to receive the amnesty will include those with tuberculosis, women, minors, and first-time offenders.

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